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MacKenzie Scott’s giving model is deceptively simple: back strong local operators, write large unrestricted cheques, and let leaders choose where the money does the most good. In Sub-Saharan Africa, that approach has translated into US$385 million between 2019 and 2024, with grants clustering in health systems, girls’ education, agriculture, research and climate restoration. It’s a bet on capacity rather than one-off projects, and—at least among the largest recipients—it is starting to show.
The geographic footprint is broad but not random. Kenya stands out as a frequent theatre of activity, alongside Ghana, Senegal, Rwanda and Niger—countries where long-running local institutions can absorb money quickly and work with governments without losing pace.
Below, the ten largest beneficiaries and the tangible signals they’ve posted so far.
Amref Health Africa — $50 million (2021)
Nairobi-based Amref is the archetype of systems work: training health workers, strengthening clinics and running community programs across East and Southern Africa. The headline benefit of an unrestricted grant is resilience—keeping programmes moving when bilateral flows wobble. In the last two years, Amref has leaned on flexible funding to steady supply chains, retain staff and protect core services when external politics turned choppy.
CAMFED International — $25 million (2020) and $20 million (2023)
CAMFED’s girls’ education model is built on density rather than spectacle: scholarships, yes, but also a continent-wide alumnae network that mentors younger girls, supports livelihoods and feeds leadership back into local government and school systems. The telling metric isn’t just enrolment—it’s completion and the spread of alumnae-run initiatives. Recent reports point to hundreds of thousands supported each year and tens of thousands of alumnae in decision-making roles, a sign the network is maturing rather than thinning out.
Restore Local — $25 million (2023)
A newer, continent-spanning push to restore degraded landscapes through locally led “restoration hubs.” The promise is twofold: measurable hectares restored and household incomes rising as trees and soil recover. The guardrail will be verification—survival rates, farmer earnings, biodiversity—rather than romantic seedling counts. Early momentum is anchored in partnerships with established African conservation and forestry actors, which should shorten the distance from plan to field.
Living Goods — $25 million (2022)
Living Goods works with governments to equip community health workers with digital tools, medicines and supervision. The organisation’s value shows up in coverage: more children immunised on time, more pregnant women registered early, fewer stock-outs. Flexible money here buys operational continuity—keeping the backbone of last-mile care functioning when fiscal cycles in health ministries slip.
VillageReach — $20 million (2022)
Born as a vaccine logistics experiment in Mozambique, VillageReach has grown into a technical partner on cold chain and last-mile delivery across multiple countries. The move from “run a truck” to “rewire a system” is the quiet story: route design, data, equipment maintenance, and the habit of on-time delivery that immunisation programmes depend on. It isn’t glamorous, but it is how needles, drugs and diagnostics arrive when and where they should.
Tostan — $20 million (2021)
Senegal-based Tostan’s method—patient, rights-based community dialogue—has been associated with declines in female genital cutting and child marriage in parts of West Africa. The point of unrestricted funding here is fidelity: staying with communities long enough for norms to shift and hold. Few social programmes have credible evidence of durable norm change; Tostan is regularly counted among them.
One Acre Fund — $20 million (2020)
The smallholder organisation remains a bellwether for the “efficiency per dollar” school of development. After commodity shocks and weather volatility, 2023 forced a difficult restructuring in Kenya; by 2024, published figures pointed to improved cost-effectiveness and a more disciplined footprint. The candid reset is the story: flexible capital let the team refit the model without losing the agronomy and input pipelines farmers rely on.
African Population & Health Research Center (APHRC) — $15 million (2022)
APHRC sits upstream of service delivery—generating evidence and policy analysis in Nairobi that filters into cabinet memos and budget notes across the region. The gains are subtle but consequential: better data on urban health, education and reproductive health, and a pipeline of African researchers who stay in the system. Unrestricted funds in a research shop buy time for longitudinal work and talent retention, the tedious essentials of policy impact.
Sentinel (Broad Institute & ACEGID) — $15 million (2020)
A West African genomics partnership linking Nigeria’s ACEGID with global research partners. The outcomes are concrete: more scientists trained, faster sequencing, and a new genome centre that reduces the region’s dependence on overseas labs when pathogens emerge. If the next outbreak is detected earlier and contained faster because the lab and people are in-country, that’s returns on a long timeline—precisely what flexible philanthropy is meant to underwrite.
Collectively, these grants point to a philosophy: spend where absorptive capacity exists and where marginal dollars tilt systems—not just outputs. The risks are familiar to anyone who has funded execution in Africa. Government co-financing can be unpredictable; global politics ricochet across clinics and classrooms; the weather refuses to cooperate. None of that is solved by private money. What unrestricted grants can do is hold the line: keep nurses paid, data flowing, trucks maintained, alumnae networks intact and labs powered until the next budget round lands.
There’s a reasonable challenge to make of Scott’s approach—show more common metrics, published on a clock. Some recipients already do it: community health programmes tracking immunisation upticks; agricultural programmes reporting profit per dollar; restoration efforts moving to independent verification. Standardisation across portfolios would help the public judge impact without turning lean organisations into paperwork factories.
For now, the shape of the $385 million is clear enough. It’s not a museum wing or a ribbon-cutting. It’s salaries, software, fridges, trucks, textbooks, training, field officers, alumnae leaders and lab benches. In other words: the unglamorous infrastructure of progress. That is where this money lives—and where, if the early signs hold, it is earning its keep.
